A clinical oncology unit typically handles patients receiving chemotherapy and/ or radiation. Aside from that, patients receive information on how their condition progresses and settle on the next steps together with health workers. Ideally, each case deserves the attention of an interdisciplinary team that could view it from different standpoints and uses the expertise of each member to ensure a patient’s well-being. However, building such a team is a challenge on its own. This paper explains how the iCARE concept can be applied to improve the work of an interprofessional nursing team in a clinical oncology setting.
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Compassion is an essential element of nursing practice as it allows a nurse to understand what the other person might be experiencing. In a clinical setting, compassion cannot and should not be a distant, unattainable ideal. Instead, it is best if compassion finds reflection in acts of help and service, no matter how small they are. One intervention that nurses might consider undertaking to promote empathy on the oncology floor is active listening. Active listening is one of the key techniques recognized by the subfield of therapeutic communication. Listening to someone actively means making an effort to truly understand another person’s point of view instead of getting across one’s own point (Ramezani, Ahmadi, Mohammadi, & Kazemnejad, 2014). If applied properly, active listening may help oncology nurses to attain two goals at once. In the short term, a nurse will be able to collect more information about a particular patient, which can be later implemented when developing a treatment plan in the long run. However, active listening may lay a foundation of trust between a patient and nurse, which may also prove helpful.
Active listening has its own strategies, the most popular of which are demonstrating concern, providing verbal affirmation, and asking specific questions. In a clinical oncology setting, a nurse needs to make sure that patients feel that they are cared for, which may be attained by expressing concern for their well-being. Confirmation is another valuable concept through which a patient may feel heard and understood. Lastly, asking specific questions allows a nurse to govern the discussion and to make it take turns so that he or she can focus on particular aspects.
Advocacy in nursing means preserving human dignity in patients and making sure that their rights and liberties are not violated in the treatment process. To ensure advocacy, nurses need to take a holistic approach toward health care and see people not as their conditions but as a unity of body and spirit. The philosophy of holism allows for promoting compassion and paying more regard to self-reflection. One thing that a nurse might consider to help the right cause is to address discrimination in the workplace. It is true that legally, all people have the right to equal access to healthcare services. However, in actuality, specific groups of people often face barriers when trying to receive the necessary help.
Oncology is a field where an inappropriate decision can cost a patient’s well-being or even their life. Yet, there are still incidents that prove that racial discrimination is pretty much present and barely addressed. For instance, Bridges (n.d.) provides an example of a study that showed that in 400 US hospitals, Black oncology patients were not treated equally. They would receive cheaper and more conservative treatment options. Black female breast cancer patients would wait for a mastectomy with no definite results way longer than their White counterparts. Ir is readily imaginable how neglecting a particular group of patients may moderate their survivability. Thus, to promote advocacy in the workplace, nurses need to stand up for those who are mistreated by the system.
In nursing, resilience is an important quality to have. In clinical oncology settings, in particular, being resilient means staying functional and disciplined despite being under stress. A resilient person may respond to stress just like any other person as pain, frustration, and uneasiness are universal. However, someone who possesses psychological strength is able to “bounce back” and restore oneself after a stressful event. Resilience is needed to fight nursing compassion fatigue, a well-described phenomenon that accounts for mental disorders in health workers and high turnover rates (Sacco, Ciurzynski, Harvey, & Ingersoll, 2015). Nurses exhausted by their work responsibilities suffer themselves and jeopardize their patients’ safety and well-being. Therefore, it would be inconsiderate and even dangerous to dismiss the emotional aspect of nursing.
An intervention appropriate for building resilience in nurses should revolve around mindfulness. A mindful approach to nursing and to life, in general, implies that through the process of self-reflection, a person addresses inner conflicts and suppressed emotions. By unveiling what has been hidden, a person gets a chance to transform their personality for a better quality of life. In the case of nursing, mindfulness may be fostered by referring struggling nurses to a therapist who will then think of a good strategy to tackle their issue.
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Drawing on scientific evidence is the new standard in the medical field. Employing evidence-based practices means relying less on opinion and experience and more on objective facts and data. Despite the proven advantages of evidence-based medicine, the healthcare system remains too rigid to accept it wholly. In nursing, there are both personal and organizational barriers to introducing evidence-based practices. The former concerns nurses’ attitudes toward continuing education. Some might not be able to see the value of new knowledge, while others cannot budget enough time and other resources to research literature and think of ways to improve their daily workflow.
Organizational factors typically include inadequate scheduling that leaves nurses too overwhelmed and exhausted to be going the extra mile. In this case, an appropriate intervention would be supporting nurses in their pursuit of knowledge. For instance, if a nurse wishes to enroll in a study program that would take his or her expertise to another level, a medical facility should be in favor of this change. Supporting may mean rearranging their schedule so that they could pay attention to both work and education.
Oncology is a field of medical knowledge that requires a specialized clinical setting, as well as specific personal and interpersonal skills, from the staff. Working with oncological patients may prove to be both emotionally and physically straining. Like other individuals with a chronic condition that interferes with various aspects of life, cancer patients need ongoing care and monitoring. The condition is scarring emotionally for each party involved, and not every health worker can withstand the psychological burden alone. Building an interprofessional team takes iCARE – compassion, advocacy, resilience, and evidence-based practice. Compassion is built through active listening, through which a nurse may establish a better rapport with patients. The same trait may allow a health worker to be an advocate for patients’ rights and promote equality. Resilience is especially needed in oncology and may be fostered through mindfulness exercises. Lastly, raising awareness of evidence-based medicine is possible through continuing education, for which each medical facility should show support.
Bridges, K.M. (n.d.). Implicit bias and racial disparities in health care. Web.
Ramezani, M., Ahmadi, F., Mohammadi, E., & Kazemnejad, A. (2014). Spiritual care in nursing: A concept analysis. International Nursing Review, 61(2), 211-219.
Sacco, T. L., Ciurzynski, S. M., Harvey, M. E., & Ingersoll, G. L. (2015). Compassion satisfaction and compassion fatigue among critical care nurses. Critical Care Nurse, 35(4), 32-42.